Two Cases of Reversible Leukoencephalopathy, Caused by 5-Fluorouracil, Presenting as Akinetic Mutism

ABSTRACT

We experinced 2 cases of reversible leukoencephalopathy, caused by 5-Fluorouracil derivatives(carmoful), presenting as akinetic mutism. Each patient was diagnosed as colon cancer and stomach cancer respectively and received operations. Their outcome was good without metastatic evidences, and carmoful was started orally 400mg in 1 case and 600mg in the other. Their clinical pictures were akinetic mutism, one and two months after the administration of carmoful. There were no metastatic lesions in the brain CT but bilaterally symmetric diffuse low densities of cerebral whites matter, predominantly in the frontal area, were noted. Carmoful was discontinued and replaced by conservative treatment. One and two months later, their clinical symptoms improved without specific treatment. Follow up brain CT was done in case 2, which revealed attenuation of the previous low densities.